Growing By Leaps And Bounds - Living Control Systems

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The Leaping Hurdles Story Slide 1 This file: LeapingHurdles.pdf This file adapted by Dag Forssell from Dr. Plooij’s original 2007 PPT prestentation, including the text that accompanied each slide. Where the manuscript is long, slides have been duplicated so text can continue on the next page at a legible size. Growing by leaps and bounds Infant mental development is characterized by predictable, age-related regression periods that coincide with a new perceptual capability and are followed by a whole new set of skills. Page format, 8.5 x 15.1 inches designed for 16 x 9 ratio, typical of contemporany computer displays, such as 1920 x 1080 resolution. In the U.S., this page can be printed on legal size paper, with a minor size adjustment to shrink from 15.1 inches to 14 inches.

The Leaping Hurdles Story Slide 2 Leaping Hurdles In this second keynote address, Dr. Frans X. Plooij introduces Leaping Hurdles—a parental support, education, and abuse prevention program based on The Wonder Weeks. In his first keynote address, Dr. Frans X. Plooij introduced The Wonder Weeks—the story, the research, and what the information means to parents and others working with infants.

The Leaping Hurdles Story Slide 3 www.fourwinds.jp The FOUR WINDS Association for Infant Mental Health is made up of professionals involved with infants, such as pediatricians, infant psychiatrists, psychologists, nurses, teachers, and daycare center leaders. The association held its annual conference on November 24-25 2007, in Tochigi, Japan, with 841 participants. Dr. Plooij was invited foreign lecturer and keynote speaker, presenting talks about The Wonder Weeks and Leaping Hurdles. See also About FOUR WINDS in the last slide.

The Leaping Hurdles Story Slide 4 Ladies and gentlemen, ‘Leaping Hurdles’ A primary prevention Parental support and education program Before starting this presentation I would like to express my gratitude to the organisation “The Four Winds” in general and to the president Dr. Kei Sawada and to Dr. Hisako Watanabe in particular for inviting me to Japan to present these lectures. It is a great honor for me. I am going to talk to you about the primary prevention, parental support and education program “Leaping Hurdles”. An overview of what I am going to say is presented in the next two slides.

The Leaping Hurdles Story Slide 5 Overview: rationale and setup The need for parental training The idea behind ‘Leaping Hurdles’ The setup of ‘Leaping Hurdles’ The setup of the evaluation research No author’s notes on this page

The Leaping Hurdles Story Slide 6 Overview 2: Data and discussion Qualitative judgment by parents The effect of the training on parents The effect of the training on babies Qualitative findings and suggestions Comparison with other successful intervention programs No author’s notes on this page

The Leaping Hurdles Story Slide 7 So let’s start with the first major point, the need for parental training. Parents have a great need for information and advice on how to raise their kids in day to day life. This was shown by an extensive study in the south of the Netherlands. The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA

The Leaping Hurdles Story Slide 8 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA However, such information and advice is often based on mere ideas and subjective opinions.

The Leaping Hurdles Story Slide 9 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA Instead, they should be grounded in scientific, direct observation of daily parent-infant interaction processes in their natural environment. These processes can change from week to week. So, longitudinal studies and frequent sampling are required.

The Leaping Hurdles Story Slide 10 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA The studies on regression periods have provided this solid, descriptive base, as we have seen yesterday. In addition, the parent-infant conflict that comes with the regression periods can escalate under suboptimal circumstances. This may lead to neglect and even abuse. Neglect may lead to more illness and/or aggression in the baby.

The Leaping Hurdles Story Slide 11 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA A training should give the parents an eye for these processes. A training that makes parents aware of these difficult periods, that such difficult periods are part of normal development, that neither the parents nor the baby are to blame, that explains why these periods are important for the baby’s development, that explains that the baby’s difficult behavior signals a readiness for learning new skills, and that explains how parents can facilitate this learning. Such a training can support parents to get through these difficult periods and prevent abuse of and illness and aggression in the baby. But there is more. Such a training helps parents to become good observers of their baby’s behavior, to find the key to their baby’s personality, to find his preferences and talents. All this leads to an optimal learning in the baby and it extends the parental skills: they feel more sure of themselves and start interacting without having to think about it.

The Leaping Hurdles Story Slide 12 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA The couple Hanus and Mechtild Papousek have called this ‘intuitive parenting’. The explosion of frame-to-frame video analysis of parent-infant interaction over the last few decades has shown that the quick succession of these exchange episodes bear the characteristics of learning situations. Without being aware of it, the parents provide their babies with didactic support. This can only come to full fruition if the participants are in a stress-free mental state. Unfortunately, this is becoming increasingly rare in our Western world. Therefore, this stress-free mental state should be realized before talking about anything else.

The Leaping Hurdles Story Slide 13 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA Empowering parents fosters intuition. Some people think that intuitive parenting emerges automatically and that one does not need to do anything, and that giving a parental training is nonsense. Unfortunately, that is not true. There are conditions where the intuitive parenting is hampered. These are clinical reasons such as a handicapped child or a mismatch between the personalities of parent and baby. Apart from these rare clinical conditions there is one reason that applies to many people nowadays. Fewer and fewer people know how to care for a baby through the observational learning they did in their extended family when they were young. Many have not even lived in a house with a baby until they get one themselves. Then it is no shame to follow a parental support and education program. This program should not tell parents what to do. It should not give prescriptions. It should give the parents an eye for the processes going on, through information together with audiovisual means. This leaves the people the command over their own lives and strengthens their intuition. It is called ‘empowering parents.’

The Leaping Hurdles Story Slide 14 The need for parental training A great need for information and advice Not based on ideas and subjective opinions Grounded in scientific, direct observation Studies on regression periods provided this Training gives an eye for these processes Intuitive parenting in stress-free state Empowering parents fosters intuition Primary prevention and WHO’s strategy HFA This brings us to Primary prevention and the WHO’s strategy HFA. I don’t know about the situation in Japan, but in the Netherlands there is a steady increase in children with behavioral disorders. These children are difficult to handle and need to be sent to special schools. Furthermore, more and more children enter primary school who are way behind normal development and have great difficulty catching up. Professionals involved in schools therefore argue that primary prevention should start as early as 2-3 years when a playful preparation for schools is concerned. Professionals involved in behavioral disorders, neglect and abuse are convinced that the age of 2-3 years is too late to start primary prevention. Then the evil has already happened according to them. Primary prevention should start at birth or even before. The costs for such an early primary prevention are only a fraction of the costs and misery society has to live with later if nothing is done. Such primary prevention is in line with the policy of the World Health Organisation called: ‘Health for all 2000.’

The Leaping Hurdles Story Slide 15 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying a parental support and education program The aim of ‘Leaping Hurdles’ The idea behind the parental support and education program ‘Leaping Hurdles’ is the following major point in this presentation. After our discovery of age-linked regression periods, we started to tell family, friends and connections about it whenever they complained about ‘more crying’, ‘cramps’, ‘not wanting to suck’ or anything that worried them about their baby. Those parents, in turn, gave us feedback about the end result, what they had done and how they had felt. This circle of people grew ever larger. We grew convinced that all parents had a right to know about the regression periods. So we wrote the parenting book “Oei, ik groei!” in Dutch. As I told you yesterday, the book was translated in eleven languages under the title “The wonder weeks” from America to Japan. This book is not a reading book but a workbook. It grows with the baby, so to speak, and parents can write down their own observations in a kind of diary. As soon as we had written another regression period or ‘leap’ in the development of the baby, we gave it to the parents around us with babies of the right age. IN doing so, we found out that parents are deeply interested in the development of their baby (as long as the information is practical and taken from everyday life). They had many questions and came up with nice contributions of their own. It was then that we decided to design the parental support and education program ‘Leaping Hurdles’ alongside the parenting book.

The Leaping Hurdles Story Slide 16 part 1 of 2 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying a parental support and education program The aim of ‘Leaping Hurdles’ The theory behind the book is already familiar to you, so I will only briefly summarize it here. The mental development of infants in the first 20 months or the sensorimotor period does not proceed gradually, but in leaps and bounds. Each leap is age-linked and has three phases: first, the regression period; second, the phase in which new skills are learned and in which mother-infant conflict occurs more frequently; and third, the easy period. Unfortunately, the easy period is rather short. The regression period is, so to speak, the visiting card signaling the next leap ahead. The baby enters a new perceptual world. This new world is unsettling and the baby retreats towards a safe base: back to mama. The conflict period is a time of new learning and de-learning. Parents discover all of a sudden that their baby is doing or trying to do new things. That makes the parents proud and they are more prepared then ever to help and facilitate their baby’s learning. Simultaneously, the parents realize that their baby is developing a new grip on the new world and, consequently, their worries over their baby’s irritability turns into annoyance. They do not accept the increased dependence on them anymore and demand from their baby that he does the new skills himself that he is now able to do. These parental demands help the baby to learn new skills and de-learn old habits and privileges. This is a wonderful interplay between parent and infant. The easy period is the silence before the next storm. For a little while, the baby is more independent, plays alone for longer stretches, and is more cheerful. Soon, however, the next regression period arrives and the whole process starts all over again.

The Leaping Hurdles Story Slide 16 part 2 of 2 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying a parental support and education program The aim of ‘Leaping Hurdles’ Continued Independent brain research has shown so far that brain-changes co-occur with seven out of the ten regression periods. This was measured through Electro Encephalo Grams (EEG’s), glucose metabolism in the brain, Evoked Response Potentials (ERP’s), head circumference, and tone of voice. These brain changes co-occur with or slightly precede the beginning of the regression periods. The theory assumes that these brain changes are the cause of the drastic changes in the way in which the baby perceives the world around him and inside his body. This new type of perception is unsettling and creates chaos. The baby needs time to create order out of this chaos again. With this new type of perception the baby gets a new type of learning at his disposal. What actual skill he develops with this new type of learning differs from individual to individual and depends on individual differences, personal circumstances and society and culture at large.

The Leaping Hurdles Story Slide 17 part 1 of 3 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying the parental support and education program The aim of ‘Leaping Hurdles’ The idea behind the parental support and education program developed as follows. In our research concerning the regression periods we collected data in several ways. On the one hand we studied the opinions of the mothers through interviews, questionnaires and weekbooks. On the other hand we observed mother-infant interactions in the home environment directly. If mothers were child-following, the direct observation measures reflected the mother’s experience. This implies that we measured more time spent in physical contact when the mother reported the baby to be more clingy and cranky. And, the other way around, we actually measured less time spent in contact when the mother reported the baby to be easy. If mothers were not child-following, operated on a four-hour feeding schedule and let their babies cry, then our direct observation measures would not reflect the baby’s need for proximity as reported by the mother. A small baby is still unable to restore bodily contact with the mother, if the mother refuses to come to him. It takes two to tango. From our questionnaire and interview data we could see that those mothers were well aware of the baby’s craving for contact, but they refused to respond to it, because they were afraid that would ‘spoil’ them. Such a maternal attitude resulted in many short separations between mother and baby by letting it cry in its bed or leaving it alone too long in the playpen. This frustrated the baby’s need for body contact and attention. Such minor life events or daily hassles produce stress and such stress has been shown to have long- and short term consequences for the bodily and mental health of the baby. This idea is supported by experimental research on animals.

The Leaping Hurdles Story Slide 17 part 2 of 3 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying the parental support and education program The aim of ‘Leaping Hurdles’ Continued . In the short and long term the vulnerability for diseases increases. Negative experiences in early infancy can lead to a dysregulation of physiological functions, which may last into adulthood and can result in a permanent vulnerability for illnesses and disease. Negative long term changes in social behavior as a result of mother-infant separation have been shown experimentally in primates. In our own species severe disturbances of the mother-infant relationship results in excessive aggression in the child, later delinquency, and child abuse in the next generation. This is called the intergeneration cycle. This cycle comes into existence as follows. One year old babies can be quite aggressive already. When these children enter the day-care centre at the age of 1-3 years, they attack or threaten to attack their peers or even the caretakers. Such behavior in the day-care centre predicts behavioral problems in primary school. And their is a frightening continuity between behavioral problems in primary school and delinquency at an adult age. The question remains how babies of one year have grown so aggressive and whether less severe forms of neglect and abuse can also result in such aggression. It is for sure that the contact- and distance regulation between mother and infant has something to do with it. For instance, it was shown that at the age of one year the babies of mothers who disliked bodily contact in the first three months, regularly showed rage while biting and slapping the mother. Main and Goldwyn discovered a continuum of intermediate forms between normal distancing between mother and infant and child abuse. Therefore they expected that a descriptive study of the normal, day to day distancing between mother and infant and the accompanying conflicts might give more insight into the escalation of such conflicts, which might lead to aggression and abuse.

The Leaping Hurdles Story Slide 17 part 3 of 3 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying the parental support and education program The aim of ‘Leaping Hurdles’ Continued Our fundamental studies have produced such insights, indeed. Every regression period is followed by a period of conflict. At first, mothers are worried when their babies are off balance and showing the three C’s: Crying, Clinging, and Cranky. But soon the mothers become annoyed, especially when the three C’s lasted too long. Mothers reported that they could not cope anymore, because they felt tired, exhausted, and sucked empty. Some mothers would admit that they had taken it out on their baby: for instance they had shouted at him, laid him down in bed more forcefully than necessary, or handled him more roughly during changing nappies. Those mothers felt guilty afterwards. One mother reported that before she had her baby she could not imagine that anybody would ever abuse her baby. But now she could if the circumstances would be bad. Concluding, during the regression periods the dividing line between normal motherinfant conflict and child abuse is very thin. These regression periods are vulnerable periods and prone to escalation of mother-infant conflict. Therefore, it is only logical that a parental support and education program focuses on these difficult periods.

The Leaping Hurdles Story Slide 18 The idea behind ‘Leaping Hurdles’ Preliminary experience with parents The theory behind the parenting book The idea underlying a parental support and education program The aim of ‘Leaping Hurdles’ The aim of the parental support and education program “Leaping Hurdles” is given in the name: to help every parent-baby pair leap over a number of hurdles without falling flat on their face. This aim is reached by attending to the following points: Make sure parents have or develop ‘an eye for’ the natural processes in their interaction with and the behavior of their baby. Teach them how to observe and how to react in a child-following way. Make parents aware of the difficult periods, make them accept that their baby is Crying, Clingy and Cranky at times and that he cannot help himself. Teach them how they can comfort their baby and help him. If they succeed, this results in a feeling state of safety in the baby and a relative stressfree state of mind. As a consequence, the baby should be less ill, among other things. A stress-free state of mind gives the baby the opportunity to explore his world without any worries. Help the parents discover what new kind of things are interesting to their baby after each developmental leap and teach them how they can facilitate the resulting new type of learning. This gives parent and baby more fun which in itself is healthy. Furthermore, it gives the baby a maximum of time to occupy himself with the new things and learn more. By taking control over all this themselves, parents start feeling more sure of themselves. It empowers them. In the program the parenting book “The wonder weeks” is read together with the parents, one leap at the time. The additional value of the program on top of the value of the book is that it prevents a too one-sided focus on learning and performing of the baby, that mothers can check whether they have understood the book correctly by discussing the examples of their own baby’s behavior, and that they learn to understand that babies can be equally advanced in their development as compared with other babies, although they attend to and develop different skills first.

The Leaping Hurdles Story Slide 19 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer This brings us to the next major point in this presentation: The setup of the parental support and education program ‘Leaping Hurdles’. The name ‘Leaping Hurdles’ symbolizes that the runners leap over the hurdles at approximately the same time. The age difference (corrected for being born too early or too late) should not be more than 3 weeks, because initially the regression periods follow each other every 3 weeks. All babies should be busy with the same developmental leap. It might be confusing when more than one leap is explained to the parents. Furthermore, parents tend not to be interested in leaps that are yet to come or leaps that their baby has left behind him.

The Leaping Hurdles Story Slide 20 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer The groups in the program are composed of minimally 4 and maximally 8 babies. A collection of less than 4 babies does not deserve the name group and a group of more than 8 babies becomes too busy, since not only the mother, but also the father, the grandmother, the grandfather, the babysitter, a friend, or even the dog are welcome to attend.

The Leaping Hurdles Story Slide 21 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer There are 11 meetings for each group. The way these meetings are Planned can be seen in the next slide.

The Leaping Hurdles Story Slide 22 Planning meetings One meeting during pregnancy, some 5 weeks before delivery. In this meeting the setup of the program is explained. The kind of information given in the program is described globally. Then the first 4 weeks after delivery are treated in more detail. Eight meetings in the first year, shortly before the next regression periods starts. In between those meetings parents can call a helpline if they have problems or questions, or if they want to talk about something. The last, unwinding meeting, shortly after the regression period around 15 months. This is done on purpose to give the parents the experience of going through a regression periods independently, and yet, to give them the opportunity to talk about it afterwards. In this meeting we discuss what the toddlers go through in the leaps around 15 and 17 months, but this time we do it more globally. The leap around 15 months receives more attention. Of the last leap around 17 months we only give some keywords. Finally, we pay special attention to speech- and language development. We assure the mothers that they can phone if they deem this necessary. The farewell party is held to finish the program formally and tell the mothers that “they can go it alone by now”. All parents and toddlers of all groups get together simultaneously. All meetings are held in a large room of at least 40 square meters. A cushion for changing nappies, a bottle warmer, toys and coffee and/or tea are available. SPRONGEN LEAPS; Bijeenkomst Meeting; TIJD TIME weken vanaf de geboorte weeks from birth

The Leaping Hurdles Story Slide 23 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer The course of one of the eight regular meetings in the first year is as follows.

The Leaping Hurdles Story Slide 24 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer 15 minutes before the meeting starts the participants can enter the room. In this way they have time to put off their coats, unpack their bags, find a chair, admire each other’s baby and update the gossip. The meeting starts on time and lasts two hours. During the meeting the attention is focused on the baby as much as possible. Sometimes a mother starts talking about her personal problems such as bad housing, problems with the social security, lack of free time, or a new lover. If that happens, we go into it shortly, only to return to what the meeting is about: the baby, their good start together, his perfection at that moment, his dependency on his mother and their wish to make the relationship with their baby into something beautiful that will last forever.

The Leaping Hurdles Story Slide 25 The setup of ‘Leaping Hurdles’ Babies approximately the same age Groups of 4-8 babies The number of meetings per group The course of one meeting – 15 minutes for getting ready – The regression period: back to mama – Learning new skills: a leap forward to greater independence – How to integrate the weekbooks in the information transfer The first hour is spent on recognizing the regression period that belongs to the developmental leap that is discussed that meeting. The following three topics are dealt with: Learning to observe your baby and learning to feel what your baby needs The regression period marks the beginning of another leap in the development of the baby. It is a difficult period for both mother and baby. Each mother gets her personalized “calendar” of the

The Leaping Hurdles Story Slide 2 Leaping Hurdles In this second keynote address, Dr.FransX.Plooijintroduces Leaping Hurdles—a parental support, education, and abuse prevention program based on The Wonder Weeks. In his first keynote address, Dr.FransX.Plooijintroduced The Wonder Weeks—the story, the research, and what the

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